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General NPI Number Information
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NPI Number | 1649431743
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Entity Type | Organization
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Legal Business Name | ACTIVE CHOICE PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 330 OAK ST
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City | ASHLAND
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State | OR
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Zip | 97520-1808
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Country | US
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Telephone | 541-482-4744
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Fax |
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Provider Business Mailing Address
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Address Line | 242 TIMBERLAKE DR
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City | ASHLAND
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State | OR
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Zip | 97520-9085
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Country | US
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Telephone | 541-482-4744
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST AND PRESIDENT
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Name | MRS. CINDY LYNN POWELL
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Credential | M.P.T.
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Telephone | 541-482-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2882
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License Number State | OR
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